ArticleObstetrics and gynecology2021
Contraindications to Hormonal Contraception Among Postpartum Women in Texas.
Article in Obstetrics and gynecology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed, 6 citations in OpenAlex.
- Translation Validation, Software Adaptation, and Usability Testing of a Spanish Contraception Decision Tool: Protocol for a Mixed Methods Pilot Study.JMIR research protocols · 2026Article
- A Web-Based Contraception Decision Tool for Individuals With Health Conditions in US Outpatient Clinics: Protocol for a Mixed Methods Cluster Randomized Controlled Trial.JMIR research protocols · 2025Article
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4 authors at 1 institution in 1 country.
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Abstract
objectiveTo examine the prevalence of contraindications to hormonal contraception among postpartum women.
methodsLow-income postpartum women who planned to delay childbearing for 2 years or longer after delivery were recruited for a prospective cohort study from eight Texas hospitals. Women self-reported health conditions that corresponded to category 3 and 4 contraindications to combined hormonal contraception and progestin-only methods, based on the Centers for Disease Control and Prevention's 2016 Medical Eligibility Criteria for Contraceptive Use. We used mixed-effects Poisson regression models to assess characteristics associated with reporting any contraindication 6 months after delivery. We examined the proportion of women who used a contraindicated method.
resultsOf 1,452 women who completed the 6-month interview, 19.1% reported a category 3 or 4 contraindication to combined hormonal contraception (16.8% category 4) and 5.4% reported a contraindication to depot medroxyprogesterone acetate (0.1% category 4). Only 0.8% had any category 3 or 4 contraindication to progestin-only pills and 0.6% to the implant. Migraine with aura (12.4%) and hypertension (4.8%) were the most common contraindications. The prevalence of any contraindication was higher among women who were 30 years or older (prevalence ratio 1.45 95% CI 1.21-1.73), overweight (prevalence ratio 1.39, 95% CI 1.07-1.80), obese (prevalence ratio 1.55, 95% CI 1.16-2.07), and insured (prevalence ratio 1.34, 95% CI 1.04-1.74). Compared with U.S.-born Latina women, the prevalence of contraindications was higher among Black women (prevalence ratio 1.37, 95% CI 1.14-1.64) and lower among foreign-born Latina women (prevalence ratio 0.71, 95% CI 0.59-0.86). Among women with contraindications, 28 (10.3%) were using combined hormonal contraception; six (8%) were using a contraindicated progestin-only method.
conclusionNearly one in five participants had a category 3 or 4 contraindication to combined hormonal contraception. Patients at higher risk for adverse birth outcomes are more likely to have contraindications. Clinicians should counsel on contraception and contraindications prenatally to facilitate the most informed postpartum decision.
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